Tuberculous infection of the scrotum is rare and occurs in approximately 7% of patients with tuberculosis. With the rise in the human immunodeficiency virus pandemic, the incidence of opportunistic extrapulmonary tuberculosis has correspondingly increased, the genitourinary system being the most common affected site. We present a classical case of tuberculous epididymo-orchitis with clinical, sonographic and histopathological (macro and microscopic) findings as well as the precise management plan incorporated. The sonographic imaging overlap with bacterial epididymo-orchitis, malignant testicular lesions and testicular torsion is discussed. Adequate knowledge of this entity is of utmost importance to ensure a meticulous diagnosis and treatment.

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Background/Aim: The maxillary sinus is the largest paranasal sinus and represents a complex anatomical structure with significant inter-individual variation. Computerized Tomography (CT) in the assessment of the maxillary sinus yields much more information. The aim of this study is to determine the prevalence, number and location of maxillary sinus septa using CT. Materials and Methods: One hundred and thirty subjects (79 males and 51 females), between 20–80 years, with normal maxillary sinus CT anatomy, from head CT scans carried out at the Radiology Department of the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, over a period of 5 years, were studied. Head CT scans were obtained from the local data base of the CT machine and back up compact disc from the CT library. Images were taken with Neusoft Dual Slide Helical CT machine, and films were viewed on the computer monitor. Septa were identified as bony projections from the sinus walls into its cavity on axial and coronal slides. Results: In this study, septa were present in 14.23% (37 septa out of 158) males sinuses, while in females, 10.34% (27 out of 102) had septa. The overall prevalence of maxillary sinus septa was 24.62%. Conclusion: Maxillary sinus septa appear common and are capable of complicating sinus membrane surgeries. CT may be useful in surgical evaluation and planning.

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Introduction: Intracranial cystic tumors with mural nodule have been extensively studied. None of these studies have established the role of conventional, fractional anisotropy diffusion tensor imaging (FADTI) and dynamic susceptibility contrast magnetic resonance imaging (MRI) in the assessment of grade and type of cystic brain tumors with a mural nodule. Materials and Methods: This was a retrospective cross-sectional study, which was conducted at Severance Hospital. Brain MRI of 15 consecutive patients with a cystic brain tumor with a mural nodule was analyzed. Results: Among the 15 studied patients 11 were females. The age ranged from 12 to 54 years. Six of the patients had high-grade tumors. Most five of the high-grade tumors showed cystic wall contrast enhancement while none was found among the low-grade group. All high-grade tumors showed increased regional cerebral blood volume (rCBV) compared to three of low-grade tumors. Hemangioblastomas, glioblastoma multiforme (GBM) and the primitive neuroectodermal tumor showed increased rCBV while pilocytic astrocytoma, ependymoma, and ganglioglioma showed decreased rCBV. There were no difference in fractional anisotropy (FA) values between tumor grades and types. Conclusion: Postcontrast T1-weighted image and perfusion MRI showed in this study to be very useful in differentiating high- and low-grade cystic tumors with the mural nodule. FA values added no benefit to tumor differentiation. Hemangioblastoma was the only tumor with increased rCBV among low-grade tumors. GBM, which is a malignant tumor, can present as a cystic lesion with a mural nodule.

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Background: Chest trauma survivors experience a complexity of problems. Plain radiography of the chest has being the standard diagnostic tool in the initial evaluation of chest trauma patients. The aim of this study is to identify plain chest radiograph findings seen in chest trauma patients and investigate the major causes of chest trauma. Methodology: The study is a cross-sectional retrospective study designed to identify plain chest radiograph findings in all patients with chest trauma in two public hospitals in Lagos, Nigeria from June 2012 to September 2012. The data was analyzed using epidemiology information (Epi Info) software. Results: A total of 200 patients that underwent chest X-ray due to chest trauma were reviewed. The majority of the cases were of the age group of 36–45 years, followed by age range 46–55 years. The majority of the cases at the National Orthopedic Hospital Igbobi were males 71 (61.7%) while females accounted for 44 (38.3%). The figures for the cases at The Lagos State University Teaching Hospital were 63 (74.1%) for males and 22 (25.8%) were female. Clinical information revealed that most cases of chest trauma were caused by road traffic accident, followed by gunshot injuries. The most common radiograph finding was rib fracture. Conclusion: Chest injury is more common in males. The majority of the chest trauma cases were related to blunt chest trauma. Rib fracture is the most common finding in chest radiographs of patients with blunt and penetrating trauma.

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Background: Breast symptoms are not uncommon among Nigerian adult females. Most worrisome are symptoms associated with the possibility of breast cancer. Mammography is an imaging technique being introduced in third world practice as an aid for screening and diagnosis of patients with breast symptoms. Objective: To document the pattern of mammographic findings in symptomatic females referred for mammography. Methodology: Patients with breast symptoms of palpable lump, pain or nipple discharge referred to the mammography unit of the Radiology department were recruited into the study at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria between June, 2012 and May 2013. Two standard views (cranio-caudal-CC and medio-lateral oblique-MLO) were done on both breasts for each patient. Results: Study population comprised seventy-one patients aged 20 to 79 years with a mean age of 48.3 years ±9.5, and range of 20 - 70 years. Of these, forty (56.3%) presented with breast pain, twenty-five (35.2%) had palpable breast lump, while fourteen (19.7%) presented with nipple discharge. 74.65% percent of participants showed positive mammographic findings. These were a well circumscribed breast opacity (35.2%), asymmetric soft tissue density (39.4%), calcification (39.4%), breast asymmetry (8.5%), nipple retraction (7.0%), tissue retraction (4.2%), skin thickening (1.4%), and axillary nodes (9.9%). Mammography calcifications were noted in 28 cases. Four of these (14.3%) were micro-calcification, while 24 (85.7%) were various forms of macro-calcifications. Conclusion: Asymmetric soft tissue density, calcification and well circumscribed breast opacity were the commonest mammographic findings among symptomatic women in our environment. Follow-up imaging or minimally-invasive image-guided biopsy or cytology may be indicated for further evaluation.

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Intraventricular cavernomas are rare lesions with a high propensity for intraventricular hemorrhage and rehemorrhage. Those located in the trigone of the lateral ventricle are even rarer with <20 cases of trigonal cavernomas reported till date. We present a case of a mixed vascular malformation, a trigonal cavernoma with associated developmental venous anomaly (DVA) causing intraventricular hemorrhage.

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Background: Computed tomography (CT) has remained an important tool in medical diagnosis. However the radiation dose imparted to patients, especially to radiosensitive organs during a CT scan, continues to raise concern. Our aim was to determine the radiation dose to the ovary and the uterus during routine abdomen/pelvis CT examinations at the University College Hospital, Ibadan, Nigeria using appropriate dose computational methods. Materials and Methods: Technical factors and parameters were obtained for three groups of 60 randomly selected patients who had abdominal CT examinations using three machines, namely; the CT/e, BrightSpeed S and Toshiba Aquilion 64. The scanning parameters were used to estimate the patient organ doses using measurements of CT dose indexes and organ doses obtained with the aid of the ImPACT CT Dosimetry Calculator SpreadSheet based on National Radiological Protection Board conversion factors. Results: The mean total organ dose from the CT/e machine to the ovary was 11.15 ±2.48 (mGy) and to the uterus was 12.10 ±2.57 (mGy), and the mean total organ dose from the BrightSpeed S machine to the ovary was 39.2 ± 22.66 (mGy) and to the uterus was 43.05 ±24.88 (mGy), while the mean total organ dose from the Toshiba Aquilion 64 to the ovary was 33.07 ±16.86 (mGy) and to the uterus was 33.85 ±18.58 (mGy). These values were mostly comparable to but slightly higher than values of similar organ doses reported in the literature for Tanzania, the United Kingdom, Germany, and Japan. The doses to the ovary and uterus obtained varied from other international surveys by 3.8–12.9 mGy and 3.17–15.07 mGy, respectively, representing a 25–50% dose increase. Conclusion: The organ doses to the ovary and the uterus at our facility are higher than those obtainable in other countries; however, this could be substantially minimized through optimization of CT scanning protocols.

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Pentastomiasis is a parasitic zoonotic disease caused by the larval stages of pentastomes, most often Armillifer armillatus. Human infections are rarely symptomatic, and diagnosis is usually made incidentally. We report here, the case of a 60-year-old man who was diagnosed with human pentastomiasis while being worked-up and treated for multiple myeloma. The diagnosis was made radiologically based on the characteristic multiple crescentic/C-shaped opacities seen on the abdominal and chest X-rays in keeping with Armillifer species infection. He also had the compatible history of exposure to and consumption of snake meat. This is the first documented case of human pentastomiasis at our facility and to the best of our knowledge the first to be associated with snake-eating in Ghana.

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Regional migratory osteoporosis (RMO) is an uncommon disorder that predominantly affects middle-aged males, presenting as migrating arthralgia involving the lower extremities. It is a transient condition that involves joints without preexisting disease and resolves spontaneously without long-term sequelae. We describe serial imaging findings in a patient with RMO followed over a period using various imaging modalities which showed typical migrating osteopenia involving the knee, ankle, and foot.

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Aim: The aim was to prospectively study radiological regression of pituitary hyperplasia following the treatment for primary hypothyroidism by serial magnetic resonance imaging (MRI). Subjects and Methods: Seven patients (1 male and 6 females) with profound hypothyroidism were included, age ranging from 13 to 42 years. MRI for pituitary was done at first visit and on follow-up. Pituitary size on imaging was matched with baseline T3, T4, thyroid-stimulating hormone (TSH), and thyroid peroxidase antibody antibodies and TSH on follow-up. Results: By 6 weeks all patients showed clinical improvement with near normalization of thyroid function tests in most patients. The TSH normalization was well correlated with regression of the pituitary enlargement on imaging at 6 weeks. The height of pituitary gland at baseline was 13.24 ± 3.61 mm, at first follow-up 9.68 ± 1.32 mm, and at second follow-up 7.80 ± 3.95 mm. The diameter of the pituitary gland at baseline was 14.47 ± 4.14 mm, at first follow-up 11.83 ± 3.99 mm, and at second follow-up 7.25 ± 4.59 mm. The height of the pituitary gland significantly reduced in first and second follow-up (P < 0.05) and reduction in diameter on second follow-up (P < 0.05). Conclusion: Pituitary hyperplasia secondary to primary hypothyroidism regresses with treatment within 6 weeks of initiation of treatment in its height however, it takes months for reduction in the diameter of the gland. We recommend repeat imaging in enlarged and homogenously enhancing pituitary gland in patients of primary hypothyroidism at 6 weeks of initiation of treatment to prove or disprove hyperplasia.

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Our resource-limited environment notwithstanding, extensive scientific work has been published about the causes of upper gastrointestinal bleeding in our locality. Interestingly however, gastric leiomyoma is most uncommonly mentioned as one of the findings in these publications. This paper, therefore, seeks to document gastric leiomyoma as a rare cause of bleeding in our environment and highlight the need for deployment of appropriate radiology and endoscopy techniques in diagnosing upper gastrointestinal bleeds.

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Malignant peripheral nerve sheath tumors (MPNSTs) are rare soft tissue neoplasms, which occur in isolation or due to the malignant transformation of benign neurofibroma. Conventional features of MPNST are very well described. We intend to present diffusion tractography findings in a case of MPNST.

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Context: Accessory pathways (APs) are one of the common supraventricular arrhythmias encountered regularly at the Cardiac Catheterization Laboratory of Madras Medical Mission, India. Aims: The purpose of this study was to evaluate the initial outcome following radiofrequency catheter ablations of accessory pathways. Settings and Design: This retrospective study was carried out in the Cardiac Electrophysiology Department, of the Institute of Cardiovascular Diseases, Madras Medical Mission, India. Methods and Materials: Records of consecutive cases of accessory pathways following cardiac electrophysiologic studies and radiofrequency ablation carried out between January 2013 and March 2014 were reviewed. Seventy-seven cases were chosen for analysis. Statistical Analysis Used: The data were analyzed using SPSS statistical software version 15. Results: The 77 patients comprised 49 males and 28 females There was a very high success rate (96.1%). Early complications were observed in only 2 (2.6%) patients, comprising cardiac tamponade, and pericardial effusion without tamponade. There was no mortality from the procedure. 10.4% were cares of recurrence following previous RFA. Conclusions: RFA of APs was associated with a high success rate and very low incidence of complication.

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